Provider Demographics
NPI:1245565050
Name:SWANSON, ERIC J (CRNA)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:J
Last Name:SWANSON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:945 82ND PKWY
Mailing Address - Street 2:STE 3A
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4612
Mailing Address - Country:US
Mailing Address - Phone:843-449-3381
Mailing Address - Fax:843-629-9621
Practice Address - Street 1:945 82ND PKWY
Practice Address - Street 2:STE 3A
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4612
Practice Address - Country:US
Practice Address - Phone:843-449-3381
Practice Address - Fax:843-629-9621
Is Sole Proprietor?:No
Enumeration Date:2009-10-12
Last Update Date:2018-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN183471CRNA367500000X
SC20912367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered